Celiac disease is an immune
reaction to eating gluten, a protein found in wheat, barley, and rye. For those with the disease, eating gluten
triggers an immune response in the small intestine. Over time, this immune reaction damages the
small intestine's lining and hinders absorption of some nutrients. The intestinal damage often causes stomach
pain, diarrhea, and weight loss, and can lead to serious complications. A Mayo Clinic-led analysis published in 2012
estimates that roughly 1.8 million Americans have the disease, but around 1.4
million of them are unaware that they have it.

Given the serious health risk
for those suffering gluten intolerance, it is important for pastors and other
Church leaders not only to be aware of the reality, but prepared to address the
situation of Catholics with celiac disease who come to parishes and seek to
receive Holy Communion in a safe, sensitive, and compassionate manner.

The Risk of "Cross-Contamination"

For those members of the
faithful with gluten intolerance, even trace amounts of gluten can be damaging.
It is important, therefore, to be
mindful of "cross-contamination" when using either low-gluten hosts or when
offering Holy Communion to someone only under the species of wine. It might be best, for example, for the
communicant to prepare a pyx with the low-gluten host before Mass, in order to
avoid the situation of a sacristan who has handled the other hosts also to
handle the low-gluten ones. At Communion
time, then, they could approach the sanctuary together with any Extraordinary
Ministers of Holy Communion and receive the pyx from the celebrant with the
words "The Body of Christ" (or, if possible, they could be given the pyx within
the normal Communion line, provided "contamination" from handling of the pyx is
avoided). Similarly, it might be
necessary for someone who has permission to receive Holy Communion under the
species of wine alone to prepare before Mass a chalice, which will not be part
of the commingling rite and from which either they alone will receive or from
which they will be the first to receive. Such precautions are not only medically necessary, but they demonstrate
compassion to avoid singling out those who want to receive Communion, but are
unable to receive one or the other species.

Low-Gluten Hosts and Mustum

The most recent Church
teaching on the use of mustum and low-gluten hosts at Mass remains the letter
from then-Cardinal Joseph Ratzinger on July 24, 2003 (Prot. n. 89/78-17498), which was addressed
to the Presidents of Conferences of Bishops. In that letter, pastors and the faithful are reminded that for bread to
be valid matter for the Eucharist, it must be made solely of wheat, contain
enough gluten to effect the confection of bread, be free of foreign materials,
and unaffected by any preparation or baking methods which would alter its nature. The amount of gluten necessary for
validity in such bread is not determined by minimum percentage or weight,
though hosts which have no gluten are considered invalid matter for Mass. (In the Roman Rite, the bread prepared for the
Eucharist must also be unleavened.)

Mustum is defined as grape
juice in which fermentation has begun, but has been suspended with the result
that its alcohol content (usually less than 1.0%) does not reach the levels
found in most table wines. It should not
contain additives and may be stored through freezing or other means. The process used for the suspension of
fermentation must not alter the nature of the juice in any way. The amount of alcohol needed for validity in
mustum is not determined by a minimum percentage or weight. Pasteurized grape juice in which all alcohol
has been evaporated through high temperature preparations is invalid matter for
Mass. In the United States, it is forbidden to
sell wine without the addition of sulfates as preservatives. The Church has determined that the very small
amount of sulfates is acceptable and does not make the matter invalid.

The lay faithful who are not
able to receive Holy Communion at all under the species of bread, even of
low-gluten hosts, may receive Holy Communion under the species of wine only,
regardless of whether the Precious Blood is offered to the rest of the faithful
present at a given celebration of Mass.

Permission for priests,
deacons, or the lay faithful without distinction to use mustum or low-gluten
hosts is within the competence of the diocesan Bishop. The authority to permit the lay faithful to
use mustum and low-gluten hosts in the reception of Holy Communion may be
delegated to pastors under canon 137 §1 of the Code of Canon Law. Medical certification of a condition
justifying the use of mustum or low-gluten hosts for Holy Communion is not
required. Such permission, once granted,
stands for as long as the condition persists which occasioned the request for
the original permission.

As a best practice, it is
recommended that individuals with gluten and/or alcohol intolerance arrange
through their parish the purchase any low-gluten hosts or mustum. This facilitates the oversight and good
stewardship of the pastor who is responsible as mentioned above. It also "normalizes" the practice for the
communicant, as well as keeping the purchase of liturgical supplies together in
the parish budget.

It is also worth recalling
that, through the doctrine of concomitance, the Church teaches that under
either species of bread or wine, the whole Christ is received (cf. General Instruction of the Roman Missal,
no. 282; Catechism of the Catholic Church,
no. 1390). Thus, the faithful may be
confident in the Real Presence of Christ in the Eucharist they receive, even under
only one or the other species.

Obtaining Low-Gluten Hosts and Mustum

In the dioceses of the United States,
there are four approved distributors of low-gluten hosts and two of mustum
known to the Secretariat of Divine Worship. (Any additional low-gluten host and/or mustum distributors are strongly
encouraged to contact the Secretariat so that an up-to-date listing may be
maintained.)

Conclusion

"Any baptized person not prohibited by law can and must be admitted to Holy Communion" (can. 912). It is important for pastors to make every effort to accommodate and normalize the experience of Communion for the faithful, including those suffering from celiac disease. As this article points out, such can certainly be done within the norms of Church teaching.

By accepting this message, you will be leaving the website of the
United States Conference of Catholic Bishops. This link is provided
solely for the user's convenience. By providing this link, the United
States Conference of Catholic Bishops assumes no responsibility for,
nor does it necessarily endorse, the website, its content, or
sponsoring organizations.